基于临床调查结合专家问卷的脓毒症常见证候主次症判定研究

BackgroundSepsis is the leading cause of death and critical illness worldwideand traditional Chinese medicine has certain advantages in preventing and treating sepsis. On the premise of clarifying the common symptoms of sepsisfurther establishing its primary and secondary symptoms can provide a basis for the establishment of diagnostic criteria for sepsis symptoms. ObjectiveTo explore the primary and minor symptoms of common syndromes in sepsis combining clinical investigations and expert questionnaires providing a basis for the establishment of diagnostic criteria for traditional Chinese medicine syndromes in sepsis. MethodsCollect 1 082 sepsis patients admitted to the intensive care unitsICUs of 8 hospitals nationwideincluding the First Affiliated Hospital of Henan University of Chinese Medicinethe First Affiliated Hospital of Zhengzhou UniversityGuang 'anmen Hospital of China Academy of Chinese Medical SciencesHenan Provincial People's Hospitalthe First People's Hospital of ZhengzhouHainan Traditional Chinese Medicine HospitalChinese Medicine Hospital Of Puyangand the First Affiliated Hospital of Guangzhou University of Chinese Medicine.Collect their clinical data and establish a database from May 2021 to August 2022. Using descriptive statisticslogistic regressionand artificial neural networks to analyze the symptoms of common sepsis syndromes and determine the primary and minor symptoms. Based on clinical investigationan expert questionnaire survey was conducted using the Delphi method to further determine the primary and minor symptoms of common syndromes. ResultsThe main symptoms of phlegm heat obstructing the lungs are coughexcessive phlegmyellow sputum coloretc. The minor symptoms are feverthirstchest tightnessetcThe main symptoms of intense exuberant heat toxin syndrome are high feverirritabilityand shortness of breathwhile the minor symptoms include deliriumred tongueand burnt yellow furThe main symptoms of Yangming fu-organ excess syndrome include deliriumabdominal painand fullness of the epigastric regionwhile the minor symptoms include hot flashesthirstand irritabilityThe main symptoms of blood stasis and toxin obstructiondamagesyndrome are purple and dark nailsblue and purple lipsdark red or purple tongueetc. The minor symptoms are deliriumhigh feverchest and rib painetcThe main symptoms of lung qi deficiency syndrome are coughthin phlegmand white phlegm colorwhile the minor symptoms are fatigueweaknessand spontaneous sweatingThe main symptoms of Yin deficiency and internal heat syndrome are dry coughdry throatirritabilityetc.and the minor symptoms are wheezingthirstdry mouthetcThe main symptoms of Qi and blood deficiency syndrome are fatigueweaknessdizzinessetc.and the minor symptoms are mental lethargydrowsinesslack of qiand lazinessThe main symptoms of Yin exhaustion and Yang deficiency syndrome are dizzinessrestlessnessand shortness of breathwhile the minor symptoms are mouth openingshoulder liftingdrowsinessand red tongue. ConclusionThis study clarifies the primary and minor symptoms of eight common syndromes in sepsisincluding phlegm heat obstructing the lungs syndromeintense exuberant heat toxin syndromeYangming fu-organ excess syndromeblood stasis and toxin obstructiondamage syndromelung qi deficiency syndromeyin deficiency and internal heat syndromeqi and blood deficiency syndromeand yin exhaustion and yang deficiency syndrome. These can provide a basis for establishing diagnostic criteria for these syndromes.